Advanced lung cancer inflammation index is associated with mortality in peritoneal dialysis patients

Abstract

Background There is still a very high morbidity and mortality rate for patients undergoing peritoneal dialysis (PD). The advanced lung cancer inflammation index (ALI) has been demonstrated to be associated with prognosis in multiple types of cancers. Similar to cancer, systemic chronic low-grade inflammation is one of the distinguishing features of PD patients. Therefore, we aimed to investigate the relationship between ALI and all-cause and cardiovascular mortality in PD patients. Methods 277 patients who started PD at Shaoxing People's Hospital between 1 January 2013 and 31 December 2020 were recruited and followed up until 1 July 2023. The dose-response relationship between ALI and mortality was described by restricted cubic splines. Receiver operating characteristic (ROC) analysis was performed and the area under the curve (AUC) was calculated to determine the predictive power of ALI for all- cause mortality and CVD mortality. Kaplan-Meier curves and multivariate cox regression analyses were used to assess the association between ALI and all-cause mortality and cardiovascular mortality. Result During the median follow-up of 40.50 months (interquartile range, 26.42~59.77 months), a total of 55 patients died and 31 of them died due to cardiovascular disease. Kaplan-Meier curves showed that patients in the low ALI group had significantly lower cumulative survival rate and cardiovascular cumulative survival rate than those in the high ALI group (all P < 0.001). After correcting for confounders, the risk of all-cause mortality and cardiovascular death was significantly higher in the low ALI group than in the high ALI group [hazard ratio (HR) 1.944, 95% confidence interval (Cl) 1.068~3.540, P = 0.030, and HR 2.672, 95% Cl 1.188~6.009, P = 0.017, respectively]. Conclusion A lower ALI is an independent risk factor for all-cause mortality and cardiovascular mortality in PD patients. ALI may be an effective indicator for predicting outcomes in PD patients.